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Better Collaboration Needed Among Nurses and Physicians

by Will Friedman, Ph.D. and David Schleifer, Ph.D.

Thursday, June 27th, 2013

The United States faces a looming physician shortage that threatens to deepen once the Affordable Care Act is fully implemented. This is a well-documented issue worried over in policy circles, around the dinner table and within the medical community, and discussed in a recent New York Times Sunday Dialogue. Yet it may be that the physician shortage is just one part of the problem when it comes to the supply of medical professionals in this country.

Nurse-practitioners can provide many medical services, especially in primary care and women’s health, and could therefore help fill the doctor shortage gap. Moreover, as provisions of the Affordable Care Act move forward, nurses will be increasingly called upon to improve care coordination, help reduce medical errors and avoidable rehospitalizations, and improve transitions and handoffs.

However, some research suggests that an existing nurse shortage will grow more acute, both because nursing education programs do not have sufficient capacity and because many nurses are reaching retirement. And relying on nurses to deliver care for less money assumes that nurses should be paid less than doctors.

Furthermore, in the 2010 National Survey of Registered Nurses, only one in ten nurses reported having an excellent relationship with a physician (link opens PDF). In fact, since the survey began in 2002, that figure has never been higher than 11%.

During recent deliberative focus groups with members of the public around the country, we heard many participants talk about their experiences with a lack of coordination among doctors, nurses and pharmacists. Such experiences, they felt, had put their health or their families’ health at risk and cost them money. The groups strongly supported helping medical professionals coordinate care.

The task therefore becomes not only to increase the number of doctors and nurses, but also to empower nurses to work effectively and collaboratively alongside other medical professionals. Such an approach can not only help address the need for more medical professionals but also seems relatively acceptable to members of the public.

Want to learn more about public views toward measures to make health care more cost-effective? Keep an eye on this space, or contact Megan at mdonovan@publicagenda.org and we will email you the findings of our research when they are available.



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